A few years ago, Chris Cole made an important decision. She dialed the 10-digit National Suicide Prevention Lifeline.
“Someone answered immediately, and it was someone who had been through the same circumstance and kind of knew what to say, almost like a therapist but more relatable,” said Cole, a vendor with Street Sense Media.
Now, by dialing 988, people can receive care from the same trained crisis team from the national hotline — like Cole did years ago.
Launched on July 16, the three-digit change aims to make it easier to access mental health care.
Since its inception in 2005, the National Suicide Prevention Lifeline has received more than 20 million calls. According to the Centers for Disease Control and Prevention, nearly 46,000 people died by suicide in 2020 and more than 12 million people seriously considered it.
The shift to 988 comes almost two years after former President Donald Trump signed a bipartisan bill into law to create this easy-to-remember number.
What 988 looks like in the District
When someone calls or texts the lifeline from a 202 number, they are connected to trained call takers at the D.C. Department of Behavioral Health (DBH). These mental health support specialists aid callers by teaching self-soothing tactics, helping with problem solving and practicing active listening. Call takers may also connect callers to ongoing care.
Currently, the lifeline routes calls based on area code, not geolocation. The agencies administering 988, as well as their federal partners, are working to make the lifeline’s location services more accurate. Until then, call takers will work to connect callers to resources near their physical locations.
The goal of the new number is to make care more accessible, but it also indicates an important change in the way society prioritizes mental health crises, Dr. Richard Bebout, chief of crisis services at DBH, said.
“Behavioral health belongs squarely in the rest of health care, and I think 988 treats behavioral health care as a health care crisis,” Bebout said.
Cole knows the aftermath of a mental health crisis. She said she has lost more than a dozen friends to suicide — she has even thought about what it would be like if she was no longer living.
“I’ve gone through periods where I didn’t feel important, felt like I shouldn’t be around, but thankfully, I had people around to talk me down… to get me to that next level where I could see outside of myself,” Cole said.
In her experience, many people in crisis “didn’t know they were in crisis,” Cole said. To her, this makes it that much more important that people know about the number in order to have a safe place to talk.
The resources and help Cole received have made her a proponent of the lifeline. She hopes people are not only aware of 988 but that they call or text it when there is a mental health emergency.
“I really encourage people to use the hotline before they make a decision they can’t take back,” Cole said.
Bebout referred to the July 16 rollout as a “soft launch,” emphasizing that it projects a 10 to 30% increase in call volume over the next five years.
According to Bebout, the District’s call center offers 24 hour care and has a local answer rate of 91%. That means nine out of 10 local calls are answered directly by the DBH call center. If it is not answered quickly enough, the other call is rerouted to the next available call center, where the caller will still be able to get help. The national requirement is at least an 80% answer rate.
Bebout attributes this call rate success to Mayor Muriel Bowser’s investment of $5.1 million to increase call center staff by 14 and the Community Response Team by 27, as well as a federal grant from the Substance Abuse and Mental Health Services Administration, according to a July 15 press release.
In the first weekend, Bebout’s team saw a tripling in calls to the center through the 988 line, primarily as a result of public curiosity, he said. To prepare for the launch, DBH added call takers, and the answer rate went up to 95%.
The local focus of the lifeline is important in connecting callers with the best care in their immediate area, Bebout said.
There are many programs that already exist in the District to prioritize behavioral health, including the Access Helpline at 888-7WE-HELP; a mobile crisis team that works within the Community Response Team; law enforcement trainings in mental health first aid and crisis intervention; and the Comprehensive Psychiatric Emergency Program, a center where people can receive care.
“I want to emphasize locally nothing’s going away — 988 is an add on,” Bebout said. “We do think that over time they’ll probably converge so that 988 really becomes the front door and the dominant way that people access urgent care, emergent support, for the full range of behavioral health crises.”
What the experts say
Jean Harris, president of D.C.’s chapter of the education and mental health-centered nonprofit National Alliance on Mental Illness, NAMI DC, believes the new 988 number should help people feel more comfortable accessing emergency care. In the past, people have been “reluctant to call 911” because of law enforcement’s involvement, Harris said.
In rare cases, however, 911 may still need to be dispatched because of a concern for loss of life, Bebout said. People on the line must still consent by giving the call taker information about their location.
“It may be anonymous,” Bebout said. “There are very rare occasions (when) a call taker would like to dispatch a 911 response but is not able to because the person is unwilling to share location and identify themselves.”
If a 911 response is necessary, Bebout suggests callers request a Crisis Intervention Officer. These officers have undergone training to equip them to better handle and deescalate a crisis situation.
For more information about what a call to 988 in the District will look like, Harris urges residents to call NAMI DC at 202-466-0972.
“I can tell them about what is available in D.C. that will help them when they call this number, and it won’t be a mystery,” Harris said.
The instant care callers can receive through the lifeline is “a game changer,” said Dr. Satira Streeter, executive director and clinical psychologist at Ascensions Psychological Services Inc., a nonprofit offering counseling support to residents in the District.
Streeter grew up in foster care after her mother was diagnosed with bipolar disorder. Because of her mental illness, Streeter’s mother faced many hardships, including homelessness. This childhood forced Streeter to have to understand how fragile mental health can be and made her want to help people get the support they need, she said.
“We really need to make sure that we are tapping our homeless population, our youth population — we need to be tapping them into resources, and it’s those resources that are going to make all the difference,” Streeter said.
